Corneal Involvement in Crohn's Disease: An In Vivo Confocal Microscopy Study

Ceresara, Gaia; Fogagnolo, Paolo; Cillà, Stefano De; Panizzo, Valerio; Orzalesi, N.; Rossetti, Luca

doi:10.1097/ico.0b013e3181e9ac98

Cited by 18 publications

(12 citation statements)

References 31 publications

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“…Several studies have demonstrated that long-term use of intraocular pressure-lowering treatments frequently cause chronic changes on the ocular surface6,15 due to the drug itself or to preservatives 6,20. Benzalkonium chloride is the most commonly used preservative in ophthalmic preparations.…”

Section: Discussionmentioning

confidence: 99%

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Changes in corneal parameters at confocal microscopy in treated glaucoma patients

Ranno¹,

Fogagnolo²,

Rossetti³

et al. 2011

OPTH

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Background:The purpose of this study was to evaluate corneal parameters in treated glaucoma patients, nontreated glaucoma patients, and normal subjects using confocal microscopy.Methods:Forty patients with primary open-angle glaucoma and 22 untreated controls underwent confocal microscopy of the cornea using the Heidelberg retinal tomograph cornea module. The glaucoma group was divided into two subgroups, ie, patients on medical treatment for at least two years before inclusion (with beta-blockers or prostaglandin analogs) and nontreated glaucoma patients. The following corneal parameters were evaluated: endothelial cell density and number, reflectivity, and tortuosity of sub-basal nerves. For reflectivity and tortuosity, a dedicated grading scale ranging from 0 to 4 was used. Differences between treatments were also evaluated in the treated glaucoma group.Results:Number of fibers and reflectivity of the sub-basal plexus were significantly lower in glaucoma patients as compared with controls (2.5 ± 0.7 versus 2.9 ± 0.9, P = 0.006, and 2.3 ± 0.8 versus 2.7 ± 0.9, P = 0.04, respectively), whereas tortuosity was significantly higher (2.6 ± 1 versus 2.0 ± 0.8, P = 0.007). Endothelial cell density (measured as cells per mm2) was lower in the glaucoma group comparing treated patients with nontreated patients (2826 ± 285 versus 3124 ± 272, P = 0.0003). Comparing treated patients with nontreated patients, relevant differences were found in number (2.3 ± 0.7 versus 2.8 ± 0.8, P = 0.004), tortuosity (2.8 ± 1 versus 2.2 ± 0.8, P = 0.004), and reflectivity (2.2 ± 0.8 versus 2.6 ± 0.8, P = 0.04). No differences in corneal parameters were found between beta-blockers and prostaglandin analogs.Conclusion:This study shows that differences in corneal parameters between glaucoma patients and controls may be due to the medical treatments used for glaucoma. These data should be taken into consideration in long-standing medical glaucoma treatment and in potential candidates for surgery.

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Section: Discussionmentioning

confidence: 99%

“…Confocal imaging is able to show changes on the ocular surface in a number of subclinical eye conditions 12–15. The aim of this study was to investigate with confocal microscopy in vivo the sub-basal corneal plexus and endothelial cell involvement in medical treatment of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Changes in corneal parameters at confocal microscopy in treated glaucoma patients

Ranno¹,

Fogagnolo²,

Rossetti³

et al. 2011

OPTH

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“…Corneal changes, often subclinical, were identified by this new technique in patients with systemic diseases such as diabetes mellitus [10], Crohn's disease [11], Fabry's disease [12], rheumatoid arthritis [13] and Sjögren's syndrome [14]. The purpose of this study was to evaluate corneal copper deposits in patients with hepatic and neurological WD, by means of traditional clinical examination (slit lamp biomicroscopy with Goldmann's three-mirror contact lens) and in vivo laser scanning confocal microscopy (LSCM).…”

Section: Introductionmentioning

confidence: 99%

Study of Corneal Copper Deposits in Wilson's Disease by in vivo Confocal Microscopy

Ceresara

Fogagnolo²,

Zuin³

et al. 2013

Ophthalmologica

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Purpose: To study corneal copper deposits in Wilson's disease (WD) patients by traditional biomicroscopy and in vivo laser scanning confocal microscopy (LSCM). Methods: Twenty WD patients and 20 matched controls underwent an ophthalmic examination in one eye randomly chosen, including slit lamp biomicroscopy with Goldmann's three-mirror contact lens examination and LSCM, in order to evaluate copper deposits in the peripheral cornea. Results: No control subjects had corneal changes at both traditional biomicroscopy and LSCM. Only 25% of WD patients had detectable slit lamp changes, compared with 75% with LSCM examination. All cases detected by slit lamp were detected by LSCM. A significant correlation (p < 0.01) was found between deposit intensity at LSCM and daily urinary copper excretion. Conclusion: LSCM could detect copper deposition in WD corneas in more patients than traditional examination; it may therefore provide important information in cases of suspected WD diagnosis.

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“…4,5,8 Crohn disease is a type of inflammatory bowel disease (IBD) of unclear etiology, which is both chronic and recurrent in nature. 9,10 Ocular manifestations of IBD occur in less than 10% of patients, 9,10 and include uveitis, episcleritis, scleritis, keratopathy, and corneal epithelial and stromal inflammation. 9,11,12 Corneal disease itself is not as common a manifestation in IBD, but can present as peripheral corneal opacifications and corneal thinning.…”

mentioning

confidence: 99%

“…9,10 Ocular manifestations of IBD occur in less than 10% of patients, 9,10 and include uveitis, episcleritis, scleritis, keratopathy, and corneal epithelial and stromal inflammation. 9,11,12 Corneal disease itself is not as common a manifestation in IBD, but can present as peripheral corneal opacifications and corneal thinning. 12 While skin lesions in general are common in IBD, leucocytoclastic vasculitis specifically is a rare complication.…”

mentioning

confidence: 99%

Progressive Cicatrizing Endotheliitis Associated with Leucocytoclastic Vasculitis and Crohn Disease

Rocha

Mednick

2013

Ocular Immunology and Inflammation

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Corneal Involvement in Crohn's Disease: An In Vivo Confocal Microscopy Study

Abstract: Confocal microscopy can detect subtle corneal changes in patients with CD, which may be signs of subclinical inflammation.

Cited by 18 publications

References 31 publications

Changes in corneal parameters at confocal microscopy in treated glaucoma patients

Changes in corneal parameters at confocal microscopy in treated glaucoma patients

Study of Corneal Copper Deposits in Wilson's Disease by in vivo Confocal Microscopy

Progressive Cicatrizing Endotheliitis Associated with Leucocytoclastic Vasculitis and Crohn Disease

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